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Hyperreduced left lateral living donor liver transplant in a 4.5 kg child-A first in Africa
Francisca Van der Schyff1, Russel Steyn Britz1, Bernd Strobele1
1Wits Donald Gordon Medical Center, University of Witwatersrand, Johannesburg, South Africa.
Insights
This study details the first hyperreduced left lateral segment liver transplant in Africa for a 4.5kg child with pediatric acute liver failure. This technique offers a life-saving option for very small children requiring liver transplantation.
Area of Science:
- Hepatology
- Pediatric Surgery
- Transplant Surgery
Background:
- Supply-demand imbalance in organ transplantation significantly impacts pediatric recipients.
- Advanced surgical techniques, including graft reduction, are crucial for pediatric liver transplantation.
- Living donor liver grafts, specifically left lateral segments, are utilized for small children, with a program established in Sub-Saharan Africa since 2013.
Background:
Supply-demand mismatch in solid organ transplantation is particularly pronounced in small children. For liver transplantation, advanced surgical techniques for reducing deceased and living donor grafts allow access to life-saving transplantation. Living donor left lateral segment liver grafts have been successfully transplanted in small children in our center since 2013, the only program providing this service in Sub-Saharan Africa. This type of partial graft remains too large for children below 6 kg body weight and generally requires reduction.
Methods:
A left lateral segment graft was reduced in situ from a directed, altruistic living donor to yield a hyperreduced left lateral segment graft.
Results:
The donor was discharged after 6 days without complications. The recipient suffered no technical surgical complications except for an infected cut-surface biloma and biliary anastomotic stricture and remains well 9 months post-transplant.
Conclusions:
We report the first known case in Africa of a hyperreduced left lateral segment, ABO incompatible, living donor liver transplant in a 4,5 kg child with pediatric acute liver failure (PALF).
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